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Fig. 14 | Insights into Imaging

Fig. 14

From: False positive and false negative diagnoses of prostate cancer at multi-parametric prostate MRI in active surveillance

Fig. 14

A 59-year-old patient with low-volume Gleason score 3 + 3 = 6 at non-targeted TRUS biopsy underwent MP-MRI to exclude clinically significant cancer after an increase in PSA. Axial T2W TSE image (a) demonstrates a low T2 SI focus in the left PZ (open white arrow) with restricted diffusion; note increased SI on trace b1000 mm²/s EPI and low SI on ADC (white arrows in b and c, respectively). Based on the MRI and clinical findings a diagnosis of potential higher grade tumour was suggested and a targeted repeat biopsy was performed. At time of repeat biopsy, which used cognitive registration of MP-MRI and TRUS data, no lesion could be identified at TRUS. Only one core biopsy through the left medial mid peripheral zone sextant was performed. Microscopic image from repeat TRUS-guided biopsy (d) demonstrates Gleason pattern 3 tumour. Continued in Fig. 14

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